PURPOSE To introduce and clinically validate a new method of estimating intraocular pressure (IOP) in patients with keratoconus and soft corneas with the aim of significantly reducing dependence on corneal biomechanics. SETTING Vincieye Clinic, Milan, Italy, and Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Brazil. DESIGN Retrospective case series. METHOD This study comprised participants enrolled at two hospitals on two continents. Numerical analysis based on the finite element method was performed to simulate the effect of tonometric air pressure of the Corvis ST dynamic Scheimpflug analyzer on eye globes with wide variations in thickness, geometry, and tissue. The numerical predictions of ocular behavior were used to develop a new algorithm to produce predictions of the biomechanically corrected IOP (bIOP) in eyes with a soft cornea (bIOPs). Predictions of the bIOPs were assessed in the keratoconic clinical datasets (because on average these corneas are softer) and compared with the previously developed bIOP algorithm predictions obtained for normal healthy eyes. RESULTS The study comprised 722 eyes (722 participants). The main outcome was the absence of a significant difference in IOP between healthy eyes and keratoconic eyes when the bIOP and bIOPs algorithms were used (P > .05). There was, however, a significant difference with the uncorrected Scheimpflug analyzer IOP in both groups (P < .001). Furthermore, the bIOPs predictions were significantly less affected by corneal thickness and patient age than the Scheimpflug analyzer IOP. CONCLUSION The bIOPs algorithm was more reliable at estimating the IOP in eyes with a soft cornea and was validated for use in eyes with keratoconus.

中文翻译：

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开发和验证软性角膜患者的新眼内压估计值。

目的引入并临床验证一种估计圆锥角膜和软角膜患者眼内压（IOP）的新方法，旨在显着减少对角膜生物力学的依赖性。地点：意大利米兰的Vincieye诊所和巴西里约热内卢角膜断层扫描和生物力学研究组。设计回顾案系列。方法本研究包括在两大洲的两家医院参加的参与者。进行了基于有限元方法的数值分析，以模拟Corvis ST动态Scheimpflug分析仪的眼压气压对厚度，几何形状和组织变化较大的眼球的影响。眼部行为的数值预测被用于开发一种新算法，以产生对具有软性角膜（bIOP）的眼睛进行生物力学校正的IOP（bIOP）的预测。在圆锥形圆锥形临床数据集中评估了bIOP的预测（因为这些角膜平均较软），并与先前开发的针对正常健康眼睛的bIOP算法预测进行了比较。结果该研究包括722只眼睛（722名参与者）。主要结果是，使用bIOP和bIOPs算法时，健康眼和圆锥角膜眼在IOP上没有显着差异（P> .05）。但是，两组未经校正的Scheimpflug分析仪IOP均存在显着差异（P <.001）。此外，与Scheimpflug分析仪IOP相比，bIOP预测受角膜厚度和患者年龄的影响显着更少。结论bIOPs算法在评估软性角膜眼睛的IOP时更可靠，并且经过验证可用于圆锥角膜的眼睛。